SCREENING TOOL FOR DYSLEXIA

AGE 8 10 YEARS / CLASSES 3, 4 & 5

BACKGROUND INFORMATION

Name of the Child: Gender: Girl / Boy

Class: Date of Birth:

Mother Tongue: Medium of Instruction:

Date of Administration:

Relationship with the Child: Class- / Language / Other (__________)

teacher Teacher

Scoring options:

2 = Usually, 1 = Sometimes, 0 = Never

Please note: On the screening tool, kindly depict the child's performance
with respect to other children in the same class. Please take into
consideration the respective childs home and social environment (native
language, socio-economic background etc) when evaluating the child.
 Domain Usually Sometimes Never

READING

1. Reads slowly, and/or guesses words, and/or

feels uncomfortable reading aloud.

2. Skips lines, omits letters while reading.

Example: The child may pronounce hear as "her", or
omit word(s) from the sentence while reading.

3. Difficulty in identifying sounds in words.

For example, the child is unable to say that /k/ is the first
sound in the word CATCH

4. Difficulty in understanding sentences, passages.

Problems in understanding the meaning of written
content related to what has already been taught in the
class, including material in books and on blackboard.
Difficulty in comprehending simple passages (about 6-8
lines) from story books and text books.

WRITING

5. Difficulty in forming proper letters and words. The

child writes letters and/or numbers that are inconsistent or
unusual in form and size.

6. Inaccurate copying from the board and/or book. The

child is unable to copy and/or makes a lot of mistakes in
copying from blackboard and/or textbooks. Unable to use
lines and margins properly.

7. Performs poorly on dictation. Makes frequent

spelling mistakes in common words.
 8. Difficulty in written expression
Has difficulties in expressing ideas on a given topic.
Expression is not age appropriate.

MATHEMATICS

9. Poor understanding of basic arithmetic

concepts, symbols such as +, , , , =, etc.
The child gets confused while using these basic signs
and/or is unable to understand the relationship between
these arithmetic concepts.

10. Difficulty in reporting time from wall clocks that

are not digital

11. Slow in mental calculations

For example: still continues to count on fingers, takes
significantly long time to do simple mental calculations.

COMMUNICATION

12. Difficulty in listening in class

Example: The child may ask teacher to repeat the
instruction, saying, I did not understand. Can you please
say it again?

13. Immature speech compared to classmates

Example: tractor produced as taktor.

14. Difficulty in forming complete sentences orally

Unable to speak in complete sentences or to produce
compound and/or complex sentences.

Example: I could not do the homework since I was not

well. (complex sentence); I read the English chapter,
but did not complete the math problem.
(compound sentence)
MEMORY

15. Difficulty in memorizing school content such as

multiplication tables, poems, etc.

MOTOR COORDINATION

16. Difficulty in copying or drawing simple shapes

Example: circle, square, triangle, rhombus,
pentagon and hexagon

17. Has an awkward pencil grasp

BEHAVIOUR

18. Shows a lack of attention and concentration on task.

Leaves work unfinished.
The child is easily bored in class and leaves tasks
incomplete. The teacher/parent has to constantly ask
the child to pay attention and/or to finish the task.

19. Restless or overactive.

Has difficulty sitting in one position. May disturb other
children in the class.

20. Appears to work hard to improve but is unable to

achieve.

21. Tends to be anxious/withdrawn/disruptive

Name: Signature: